Stridor 2/13/17 Dr. Yvorchuck Flashcards
3 yo TB gelding is presented w/ hx of exercise intolerance noted in the last 2 races. The horse is noted to make a respiratory noise at the time of the intolerance.
What is your dx?
Epiglottic entrapment (EE)
You endoscope a 4 yo racing QH and you see this:
Dorsally displaced soft palate (DDSP)
A 5 yo Warmblood mare is presented w/ hx of exercise intolerance & intermittant stridor for last 3 wks manifested only when used for jumping. An inpiratory & expiratory noise is heard.
What is the likely dx for this mare
EE or DDSP
not ILH d/t ILH only has inspiratory noise
A 5 yo Warmblood mare is presented w/ hx of exercise intolerance & intermittant stridor for last 3 wks manifested only when used for jumping. An inpiratory & expiratory noise is heard.
You scope the animal and see this:
What is the definitive dx for the noise as heard in this mare?
EE
You are presented with a 6 yo Holsteiner jumper mare for generation of a noise in the show ring.
You scope the animal and see this:
Idiopathic Laryngeal Hemplagia (ILH)
can’t say Laryngeal Hemiplagia because that doesn’t identify the side. ILH is Left Laryngeal Hemiplagia by convention!
You are presented with a 3 yo Trotter (Standardbred) gelding who has manifested slowed racing times in his last 2 races.
What is your dx
RLH - right laryngeal hemiplegia (LH)
Whats your dx
Axial deviation of aryepiglottic folds
What is dx
subepiglottic cyst
What does stridor w/o distress mean?
- When the horse is At Rest there is NO distress evident.*
- Horse does not evidence any difficulty breathing at rest.*
Which condition is usually only an inspiratory noise?
ILH
Which condition(s) can have both inspiratory & expiratory noise?
DDSP
EE
What type of noise is expected in upper respiratoy tract dz
inspiratory only (but of course the 2 exceptions DDSP & EE)
what are the 2 types of DDSP?
persistant
intermittant
With persistant DDSP what else are you likely to see?
evidenced endoscopically at rest
neurogenic dysfunction - dysphagia! = CS
mechanical or inflammatory mechanisms obliterating the subepiglottic space
what type of DDSP are most cases
intermittent
Keep this image in your brain!
upper resp see why obligate nasal breathers
what is pathophisiology of DDSP
excessive negative intrapharyngeal pressure
excessive poll flexion
epiglottic shortening
caudal retraction of larynx
what are commonly used terms describing head carriage in horses
“collecting” = dressage
“holding back” = racing
“checked” = Standardbred trotters
what mm dysfunction is important in the development of DDSP
thyrohyoideus mm
moves larynx rostrally & dorsally
remember only soft tissue keeps larnyx in place
IDDSP CS
intermittent: temp. obstruction at high speed
* inspiratory/EXPIRATORY noise*
“Choking down”
functional obstruction
Cough especially when eating
See head & neck extension when running
Cheek puffing
What is this?
DDSP
you lose contour of epiglottis unlike EE!
Before tx DDSP what do you need to do?
Make sure any other concurrent respiratory issues are tx first or else you might still have DDSP after you tx it!
DDSP Tx (non-invasive)
Change poll flexion
Tongue tie - Dx & Tx
Cornell Collar - Dx & Tx
tongue tie
